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Behaviour research and therapy, 88,26-36.References As a result, an extended version of cognitivebehavioural therapy (CBT) has been designed specifically for the treatment ofeating disorders, it is widely used and understood by the name of CBT-E, thatis, Cognitive behavioural therapy for Eating disorders. However, researchersclaim that these modified and specific scales are not so strictly used by thepsychotherapists as they tend to customise these manuals according to therequirement of the intensity of disorder. Whereas, it is a common belief amongscholar and researchers that CBT has been most effective for the treatment ofEating disorders since its formation, a vast number of researches available onthe topic justified this claim as well.Behavioural therapy the formulation and resultof the evolution of behaviourism. Behaviourist approach to psychoanalysisinvolves the study, inspection and understanding the behaviours to identify thecore problems in the cognition of a person. When the behavioural theoriesstarted getting popular among early psychologists, they decide to get deeperinto the analysis and therapy approach.
Therefore, the cognitive behaviouraltherapy was formed, which basically involves the treatment of psychologicaldisorders or emotional issues that has an impact on the behaviour and attitudeof patients through deeper analysis and identification of the core problem bybreaking through to the cognitive functions and cognitive values of a personand modifying them. This approach is now widely accepted and applied to thetreatment of most of the disorders all around the world. Most specifically, thesystematic approach of cognitive behavioural approach is widely implemented forthe identification and eradication of Eating Disorders among adults such as;anorexia and bulimia.Conclusion Murphy et al. (2010) also identified in theirstudy that CBT-E is a form of cognitive behavioural therapy and is communalwith other empirically maintained forms of CBT it concentrates primarily on themaintaining procedures, in this case those maintaining the eating disorderpsychopathology. It uses detailed strategies and a supple sequence ofserialised therapeutic measures to achieve both cognitive and behaviouralmodifications. The approach of treatment is parallel to other forms of CBT,that of collaborative empiricism.
Although CBT-E uses a variety of genericcognitive and behavioural interventions (such as addressing cognitive biases),unlike some forms of CBT, it favours the use of strategic changes in behaviourto modify thinking rather than direct cognitive reformation. The eatingdisorder psychopathology may be compared to a house of cards with the strategybeing to recognise and eliminate the key cards that are supporting the eatingdisorder, thus bringing down the complete house. Resultingly, the core featuresof the fixated and broad varieties of CBT-E, includes adaptations that need tobe made for patients who are underweight (Murphy et al., 2010).Banksoff et al., (2012) identified theDialectical Cognitive Behaviour therapy method for eating disorders, where theDialectical Cognitive Behaviour therapy or DBT is a multimodal cognitive-behaviouralapproach adapted in numerous ways for individuals with eating disorders who,like those with Borderline Personality disorder, may face difficulties in theregulation of their emotions. DBT has been used as a treatment for the complexcases of eating disorders that have been discussed in the former section ofthis essay and also in an altered form for less complicated cases in whichother first-line approaches alone have been ineffective. Banksoff et al.
(2012)quoted, “Many patients struggle with black-and-white or all-or-nothingthinking. An example would be, ‘Since I binged and purged today, I am a totalfailure in life.’ Looking at that same circumstance from a dialecticalperspective would be, ‘I binged and purged today, and I am continuing to workon my recovery.” Furthermore, Kass, Kolko and Wilfley (2013)separately identified the ways of treatment of anorexia nervosa and bulimianervosa, they suggested that to treat the anorexia nervosa eating disorder,Maudsley model of treatment for adults with anorexia nervosa (MANTRA) is themost prominent type of cognitive behavioural therapy (Kass et al.
, 2013).However, specialist supportiveclinical management (SSCM) is another prominent method of therapy for the treatmentof the patients with anorexia. Whereas, for the treatment of bulimia nervosaIntegrative cognitive-affective therapy (ICAT) alongside the enhanced versionof CBT, called CBT-E are the major tools to help minimize and eradicated thecognitive or behavioural causes of such disorders (Kass et al., 2013).However, Tobin, Banker and Weisbery (2007) argued on the basis of theirresearch that only 6% of the therapists adhere to the manuals designed for thetreatment of eating disorders.
In contrast, they therapists tend to merge morethan one methods or theories while treating their patient according to theirindividual attitudes. In summary, they psychotherapists use randomised andcustomised methods and manuals for treatment, which invalidates the manual solelycreated for the treatment of eating disorders (Tobin et al., 2007).Fairburn and Harrison (2003) also agree withthe fact that many psychological theories have been projected to minimize theprogress of eating disorders. In this regard, they suggest that the cognitivebehavioural theories have been most influential for the treatment of eatingdisorders. A summary of these theories can be identified as that there are twomain procedures regarding the restriction of food intact by a behaviouraltherapist that helps prevent eating disorders, where, both of said ways can beoperative at the same time. At first, the person should be able to have or atleast to feel in control of life, which gradually takes shape of the control ofeating habits. Second, is the overestimation of the body weight in comparisonto the ones who have been sensitised to the situation.
However, both instances,require highly reinforcing restriction regarding the eating habits (Fairburnand Harrison, 2003). Consequently, other procedures get activated to operateand help to preserve the eating disorder. They comprise of withdrawal fromsocial setting and groups because the fact that extreme and inflexible dietarylimitation encourages binge eating in convinced individuals and of the negativeoutcome of binge eating on apprehensions about body shape or image. Theevidence increases regarding that the modification of discussed processes isnecessary for recovery, especially in those with bulimia nervosa.As a result, since the formulation of cognitivebehavioural therapy, numerous procedures related to the cognitive behaviouraltherapy that are specific to the disorders have been created by behaviourpsychotherapists (Hoffman, 2012).
These various disorder specific protocols fortreatment may slightly differ according to the requirement of the disorder butthey are based on one core model and they follow the general CBT approach totreatment. One such protocol as identified by Fairburn et al. (2009) is CBT-E.It is a disorder specific transdiagnostic approach for the treatment of eatingdisorders. There are two specified eating disorders inscribed in DSM-IV thatare; Anorexia Nervosa eating disorder and Bulimia Nervosa eating disorder(Fairburn et al., 2009). Whereas, Agras,Fitzsimmons-craft and Wilfley (2017) postulated the third type in DMS-IVinvolves the atypical eating disorders termed in DSW-IV as ‘eating disordersother-wise non-specified’, these disorders are the untitled and unidentifieddisorders.
They can be a combination of diseases or also the changingdisorders, that is, they might take new shape or form hence cannot be specified(Agras et al., 2017). Loucas et al (2014) identified the 3 general stages ofpracticing and implementing the cognitive-behavioural therapy in the patients ofEating disorder. The three steps include; Functional Analysis-The stage of CBTwhere the individual is learning to identify problematic beliefs. Actual Behaviours-Thesecond stage of CBT where new skills are learned, practiced, and applied toreal-world situations.
Behaviour Change-Final phase of CBT that encourage anindividual to take steps towards implementing a developmental transformation(Loucas et al, 2014).Hofmannet al. (2012) explained the premise and function basis for the psychotherapy orpsychological treatment approach related to the Cognitive-behavioural therapy,commonly known as CBT. Hoffman et al.
(2012) suggest that CBT is based on theinterventions that maintain that the mental distress or psychological disordersare caused by the factors of cognitive functions. Beck (1970) and Ellis (1962)established the core premise relate to the treatment approach that themaladaptive functions of cognitions are the contributors for the maintenance ofemotional or behavioural disorders. The fundamental model postulates that thestrategies related to psychotherapy of such disorders operate by changing themaladjusted cognitive functions which as a result, lead to positive changes inthe emotional and behavioural problems (Beck, 1970).
Rachman (2017) studied the evolution ofBehaviour therapy and how it emerged as the Cognitive Behavioural Therapy.Pavlov’s work on the conditioning process can be regarded as the origin of theBehavioural therapy. The study conducted by Pavlov (1995) related toconditional learning through salivary reflexes made way for many newdiscoveries and through these discoveries with developing times he formulatedan experimental pattern for the investigation of behavioural problems. Rachman(2017) further argues in his study that the formulation of behavioural form oftreatment did sound simple, but during that era psychologists faces strong repulsionsby the medical practitioners for the proposed therapeutic method of treatment.The method was assumed as absurd by many researchers due to the fact that thesystem merely relied on the study, understanding and changing of learntbehaviours without the intervention of medicines, physiological treatments andignorance of deeper psychosexual complexes of consciousness, in short, medicaloppositions failed to find the benefits related to the mere modification ofindividual’s behaviour.
The oppositions involved the assumption ofpsychoanalysts that the extraction of neurotic causes or symptoms of thedisorder through behaviour therapy will result in the replacement of thesymptoms and they were convinced that the behaviour therapy can be harmful tothe individual’s cognition on a broader perspective, which was later, proved tobe a false assumption (Rachman, 2017). However, there was a lack of treatmentsrelated to depression and to aid the cause, as the prohibition regardingcognitive based psychotherapy started to fade the behaviour therapists adoptedcognitive concepts following the models suggested by Beck (1976). Rachman(2017) determined that Behaviour therapists set aside their uncertaintiesregarding the inappropriateness of cognitive concepts they began applyingcognitive concepts for the treatment of their patients, which resulted insuccess. After the successes involved with the therapeutic methods theremaining doubts about unacceptability of cognitive therapy were lifted,particularly when behavioural therapy was incorporated together with thecognitive therapy with emphasis on the behavioural components of cognitivetherapy. Moore (2011) conducted a study on Behaviourism.He explained how the psychological approach changed from introspection toobserving behaviour.
Watson (1913) founded the behaviourist school of thought.He claimed that Behaviourism is “purely objective experimental branch ofscience” it comprehends psychological disorders as dysfunctional or maladjustedlearning of behaviour. Baum (2011) identified in his study that it is based onthe ideology of “Tabula Rasa” meaning, a blank slate, that is, individuals areborn as a blank slate and all the behaviours are then learnt from theenvironment. Hence, the maladaptive learning causes psychological disorders.
Whereas, the method of therapy according to behaviourist approach, is based onthe idea that what can be learnt can also be unlearned (Baum, 2011).Consequently, the treatment of psychological disorders such as; eatingdisorders, bi-polar disorders, PTSD and others has evolved into CognitiveBehavioural Therapy which incorporates methods such as; classical and operantconditioning (Moore, 2011). This essay, however, focuses on the recognitionrelated to the integration of behavioural approaches for intervention ofpsychological problems in adults. The problem that will be primarily discussedthroughout the essay will be based on the treatment of eating disordersincluding, Bulimia Nervosa, Anorexia Nervosa, Orthorexia Nervosa, ObsessiveEating Disorder and others.